Provider Demographics
NPI:1750820841
Name:CASE, EVA (ARNP)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:CASE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:EVA
Other - Middle Name:GALE
Other - Last Name:CASE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:1908 N 14TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601-2039
Mailing Address - Country:US
Mailing Address - Phone:580-718-4508
Mailing Address - Fax:580-718-4508
Practice Address - Street 1:1908 N 14TH ST STE 206
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-2039
Practice Address - Country:US
Practice Address - Phone:580-718-4508
Practice Address - Fax:580-718-4528
Is Sole Proprietor?:No
Enumeration Date:2017-02-22
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK94848363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily